AcosmicRN

Yes! You need to start looking for a new place. 9 pts is not an acceptable workload for one person, except in emergencies. You should condition yourself for 7 pts on an orth/neuro/med surg floor, but anything over that maximum is not fair to you. You need to start looking for another job, while you still have one. That 7 nurses have left since you started is an obvious sign that the hospital is a revolving door. I was once told by a speaker at a convention that you should aim for the best place to work in the area you want to live in. You may not get the job tomorrow, but you should be putting in your application, trying to get on PRN, whatever. It may take a year, but so what? That year is going to pass whether you try or not. Give yourself some hope: start managing your career as a nurse now. Go for the best, even if you have to stay in the worst while you're trying to get there. At the hospital where I work, 7 is the max on a floor like yours. 6 is the usual. Acosmic

I sympathize with anyone who does that well in nursing school and then doesn't pass, but this sounds a bit like a divorce-story. You know, the kind where you only hear the one side and the one telling the story is always a saint who suffered tremendously at the hands of the other. When I was in school, it was a major effort to fail someone in clinicals. If they did, it was for a very specific reason. If you don't want to share that with us, I can understand, but it's hard to agree you were hard done by when, if I was there, I might have agreed with the decision, you know? All we are left with is that you are 57, and I feel like I'm being corralled into accepting you were failed because of an age conspiracy. Can you be any more specific on the reasons they failed you in clinical? You sound like you were a great student. Acosmic

What you all say about self-esteem is critically important, I believe. I think low self-esteem is at the root of most interpersonal problems between nurses and people in general. Acosmic

I wasn't trying to be rude with the comments about NPs, and certainly, I wasn't trying to be rude to the OP. Hopefully, I was persuading her not to be an NP. It's sound advice; that's how NPs are treated where I come from. NPs derive their status because they retain an RN, and this doesn't get them anywhere with MDs. To the MDs, they are the assitants who go and do daily rounds for them on patients who aren't critical. That's just the way it is. The nurses where I work don't consider NPs doctors, nor do they consider them part of the "RN" profession. They're just out there somewhere in-between. Granted, they typically earn more than an RN, so there you go. I would encourage anyone with a good heart, energy, and intelligence to be a nurse. I believe in nursing. The array of assitants an MD uses (PA, NP, tech, etc) is not something I'm going to encourage. I'm a nurse. The world needs nurses. There is no shortage of MDs. That's just my opinion; feel free to disagree, but don't acuse me of being everyone in this group you never liked before. It's just not me. Acosmic

The way the world is right now, there are three ways to become an RN. Diploma from a hospital based school, ADN, BSN. I haven't heard of any MSN programs that include the basic nursing school. The truth is, you are employed as an RN when you are employed. The truth is you are an RN when the state gives you that license. Promotion potential? Advanced practice? BSN Bedside nursing, staff nursing, all the things that make nursing great? ADN, diploma I chose an ADN for the following reasons: I hate managing I don't consider NPs or CRNAs to be nurses in the real sense, and I want to be a nurse. I have a B.Sc. in Liberal Arts where I studied psychology, sociology, writing, literature and science to my heart's content. I'm done with school. Bedside nursing, to me, is the greatest power a person can have. I'm going to be 40 in September; I'm clear on what I want in life. But other people have their eyes set in other directions. For me, in this time of my life, I'm through trying to climb the ladder of success as the world would have it. I have found honor, glory, power, and the keys to the kingdom of God at the bedside of patients. That's my $0.02 Acosmic

Where I work, less than a dollar an hour is given for new grads with a BSN. The hospital makes no descrimination in hiring between ADN or BSN. The managers are BSN, but not necessarily the assistant managers. In the education department, they have masters, and the main instructor isn't even a nurse, he has an MPH. I hope they make BSN the entry level position and grandfather in ADNs like me so I will get paid more as the salaries go up. Acosmic

I hear you. That sounds like a load that is too much for one RN. The max on a floor like that should be 7. Or at least that's what seems to be the norm (It really should be 6.). Why are they understaffed? Do people not show up, or does the hospital just assume nurses can work with 8 patients?The reason I ask is because where I work, we have 4 patients (an intermediate cardiac floor). It's the only place I've worked, so I wonder about how nurses handle situations like you describe. Acosmic

Well now, here's the thing: your nic suggests you have your eyes set on nurse practitioner, if this is so, I suggest you get used to this preceptor. Why? Because it's my experience that NPs work for doctors and are treated by them basically the way aids are treated by RNs, and that's only fitting. They are, after all, doctors' assitants. In some states they may have their own practices, but in mine, and in my hospital, they do all the redundant work the MD (their employer) doesn't want to do. Nurses regard them like MDs (which is not really very high) and MDs regard them as nurses (which, again is not really very high). Since being treated arrogantly and as a second class HCP is what your future holds for you as an NP, I'd use this preceptor as a good chance to get some experience at it. As a future NP, it may be exactly what you need. But, of course, you will make more money, and it's amazing what people can put up with for money. If you choose to be a real RN as a career, then my sympathies are with you, and my advice would be wholly different. Either way good luck. Acosmic

I'm curious SCRN1: I read all your reply, but I have to get some clarification on your very first point. What is your typical patient load, and what kind of floor do you work on? And, if you would indulge me, is your hospital a small for-profit hospital or is it a larger, maybe county, hospital? Thanks for your response. Acosmic

Thank you for your reply, because this is exactly what I am talking about. I have a problem. I feel a certain way, and you blame me for it. You put me down for it. You make me responsible for it and ignore the fact that I was talking about arrogant, negative people, which I think most people would agree do exist and are irritating to be around. When I read "Pro-team building," and "We strive to have the best unit in the hospital." I immediately got cold chills, because while I strive to be the best nurse I can be, I really don't want to be "on top" of anyone. Competition is kind of against my religion--whacked out as it is. You know, even the negative people on my floor smile--they have to or they get bad evaluations. But when they smile and greet you, you feel like you just got greeted by a car salesman on the lot. It's not a real greeting; it's not a real smile. They don't really like you. But you are right: I do have a problem. When I encounter a negative person or people, I can do one of three things: I can fight back, I can avoid, or I can embrace them as I would any other person with an illness. I'm not at the place where I can embrace them, but I know I need to get there. Acosmic

Indeed. They are very cliquish. They all seem to hang out together and eat lunch together. On the rare ocassion I have sat with them (if they're in the cafeteria, and no one else from work is there, I have to sit with them--it's kind of a hospital-cultural thing), I notice that they are always talking bad about somone or some patient. Even though they seem happy together--like highschool--they are engaging in conversation that can only elicit bad feelings. They are literally recharging their negativity. And I'm glad you're one of those irritatingly perky people. I'll bet you don't realize (because people don't generally tell people this) that you make the day for many of your coworkers. When I come on the floor, the first thing I look at is who's there with me, and I say to myself, "Oh, she's cool; He's friendly; She was nice to me last time; I can probably ask him for help if I need it," etc. I thank God for irritatingly perky people--so carry on our wayard son! Acosmic

Yes. I think your advice is exact, and it is all that can be done. I think one thing I need to wake up to is that the more positive I become, the less un-positive people are going to like me and the more negative they will seem to me. But if I'm any good at all at laying bricks for the kingdom of God, I need to find a way to embrace them as well. I mean, it's like you say, they really do have a problem. If that's the case, then I should regard them and treat them as I would a mentally ill patient. I have compassion for mentally ill patients, so why not mentally ill coworkers? I must find a way. Thanks for the advice. Acosmic

:uhoh21: The posters below are correct: follow your facilities guidelines for medication errors.

I'm trying to get to the root of negativity in nursing, so I was wondering what makes you drag yourself to work, what it is you hate the most about going to work, or what it is that makes you feel negative when you're at work. Arrogant people make me feel negative--especially new nurses who were just one semester ahead of me in school. They acted arrogant in school, and now they walk the floor all determined like they know exactly what they're doing and like saying "Hi" to me would be too much time out of the important things they have to do. I hate it when people try to make me feel like less than they are. I don't need to be superior to anyone, I just don't like being disregarded, and being disregarded tends to make me feel negative. What do you hate? And what suggestions do you have for me? Acosmic

No. I've never cared for anyone like that, or for that matter, seen anyone or heard of anyone with "heart cancer." Does it exist? In fact, is there any cancer that comes from muscle cells? Acosmic

I have never seen nurses pushed too hard, where I live anyway. Even in the nursing home where I worked as an aid, the nurses didn't run from room to room; they barely did anything at all until the end of the shift. But man, did they ever complain. Even in the hospitals in this area where they supposedly have understaffing, I never saw the nurses really busy. Not like the stepdown floor where I work now as an RN (and they have only 4 pts.) The stepdown floor is busy in my opinion, and it has the most professional nurses who complain the least. I hold out that there may be hospitals where a nurse has too many patients, no matter what. But the answer is not to berate nursing but rather for all the nurses to quit that particular hospital, which they eventually will, and find jobs elsewhere. But I worked in a dungeon of a nursing home, and it wasn't for lack of staff--it was for lack of staff movement that there was too much to do. In the dungeon, if everyone did their job at a reasonable pace, everything could get done as needed and on time. Nursing requires energy, no doubt. An obese, negative, lazy uncaring nurse is going to have a hard time caring for one patient, much more, ten. "Ohhh to be a new nurse," one says. But I'll be the same way in 30 years when I retire to paint dog portraits and seascapes to supplement my SSI. It's not being new, it's simply giving a darn. It's work ethic. I'm not saying I have it more than anyone else. I'm only saying that it's what is required to be a good nurse and a happy one. Acosmic

I don't even see where the TSH is high, but both books I have indicate the test in mU/ml (2-10 mU/ml) but the guide in my PDA shows it as WNL.(0.4-6 mU/ml). I'd bet its just a benign growth being that it's WNL and asymptomatic. Even so, like you say, she has the whole summer to correct it. A thyroid problem wouldn't keep someone out of nursing, I wouldn't think. I wouldn't think it would even fail them in a pre-nursing physical. But that's just my opinion. Acosmic

Nursing is the greatest profession in the world. It is the highest calling for building the kingdom of God. I have a lot of energy; I'm a mover. I jog several times a week so that I can be fit to do my job as a nurse. I keep my weight down so I can be fit to do my job as a nurse. I study and subscribe to three different nursing journals so I can be fit to do my job as a nurse. I read the Gospels and work to decipher them so that I can be fit to do my job as a nurse. I have a happy marriage and a stable home, and that allows me to be a good nurse. I am a nurse to my patients, my coworkers, my collegues, and the MDs. I'm a nurse through and through. It's what I came into this world for, I know that now, so I give it my all. If it's a cross I'm nailed to, then it is my glory. I will not berate this calling. The nurses who complain and are the most bitter are always the ones who do the least; they can never be found when their patient's call light goes off; they have the most screwed up personal lives, and they're terrible at bedside manor. In short, they hate nursing because they want the "R.N." and all the great connotations that come with it, but they really don't want to be nurses. They hate their management, but they won't look for another job. They feel underappreciated, but how can show appreciation to someone who complains day in and day out? To the original poster: Nursing is great, but it requires a great person to do it. So, be great--even as God is great. That's my advice. Acosmic

OK. I don't get it, because it sounds like it mathematically works out. two clients get the same drug One client gets twice as much as the other half way through it is realized that the drugs were switched That would mean that client A has gotten the right dosage, but client B has only gotten half the prescribed dosage, what is remaining is the other half that belongs to client B, so why not give it to client B and everything comes out in the wash? Of course this assumes that both doses are of equal concentration, but the "double dose" for client B is in a larger volume of dilutent, say 500 ml instead of 250. OK, so school me. Acosmic

Professional? What is that? Is it someone licensed by the state? Barbers are licensed by the state. Is it someone who makes money at what they do? That's the burger flipper. Is it someone who is completely autonomous in the decisions they make while performing their work? That's every self-employed person. Is it anyone who has to have a bachelor's or higher to work? Are newspaper editors considered professionals? Are FBI agents? If you take one definition, you open flood gates for all kinds of job titles. If you take another definition, you open different flood gates. Is a professional only an MD, Lawyer, CPA? Is a vocation only for priests? Perhaps a professional is anyone who puts letters after their signature? Or is it someone who directly bills a client for services rather than being paid by a third party (such as a hospital). I am an R.N. I sign it after my name, even when I'm writing checks or signing credit card receipts. My job is listed under the section of my state law called "The Professions." I have a state board that licenses me. I have malpractice insurance. I get paid for what I do. I have social respect and status. I assess patients, make diagnoses, plan interventions, conduct interventions, and evaluate those interventions. Furthermore, I am an essential element of health care. And not just a member of a team: the role of MD and RN are the two components that define healthcare. You can't have just one or the other without the whole thing coming apart. In a hospital, everyone is either an RN or an MD or working to support and assist one or the other. Nursing is older than medicine. Doctors evolved from nursing, not the other way around. I'd say that makes me a professional if ever there was such a thing. Acosmic

Should I join the ANA? How many nurses are members? I heard it was only like 5% or so. I don't want to join the ANA, because they are pro-choice. I don't care about Democrat or Republican (as I tend to switch parties quite regularly anyway) but the pro-abortion thing bothers me. Also, that they are so bent on BSN nursing is kind of irritating when most nurses are not BSN nurses (at least not currently). But maybe I'm missing something. Perhaps there are great benefits to joining. If so, what are they? Acosmic

I'm older. I've had other careers. I was a publisher (excuse me, did I say "publisher"? I meant a grossly unsuccessful publisher) an eduction counselor, and was in the military for 10 years. I have a B.Sc. in Liberal Arts and three Associate degrees of various sorts including my ADN. I came to nursing /p a religious conversion, and I love it. All I want to be is a staff nurse for the next 30 years. I hope everyone gets their BSN, because I desperately need a good manager and/or an NP who will write me orders for my pt. We need BSN nurses, but the nursing shortage is really about staff nursing. The glory of nursing, IMO, is in staff nursing. When it comes to staff nursing, you need to have an R.N. license. I have one. Personally, I think it may be better to have a BA or BSc in another feild and an ADN, If "well-rounded" is what matters. For that matter, why not require a B.Sc. and then make nursing school a masters program? I have no position either way; I see myself as an oddity in nursing, anyway (male, non-nursing bachelors, older, all whacked out religiously, etc.). As for entry level, that's for future nurses to worry about. Where I work, management requires a BSN. But I can't imagine going back to school in order to get a job doing what I consider a lesser occupation than staff nursing. JMBO (just my babbling opinion) Acosmic

You're doing the pre-reqs now, what about a CNA course in the summer? Then you would be qualified to be hired as an aid. Acosmic

Thanks all for the congratulations! Acosmic

Mandi, I mean this with the greatest of respect: you need to leave that town. You can't just live out your life in a town of 4000 people. It's deletrious to the soul. It's socially incestuous. It's what you do when you're collecting social security. Do yourself a favor, become a nurse, but for God's sake move away. Just my opinion. Acosmic